Tag Archives: public health

Corruption in Emergency Procurement: Lessons Learned in the Philippines

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As numerous observers have noted, in far too many countries the response to the COVID-19 pandemic has been hampered by widespread corruption, particularly in government procurement of medical supplies and other equipment (see, for example, here and here). As the pandemic finally recedes, it is useful to take stock of lessons learned and to implement reforms to emergency procurement procedures that will help mitigate these problems in future emergency situations.

One country where it is particularly important to address emergency procurement deficiencies exposed by COVID is the Philippines, which was mired in corruption scandals from the earliest days of the pandemic. Perhaps the highest profile COVID-19 procurement scandal—though hardly the only one—is the so-called Pharmally scandal. Over 2020-2021, the government of the Philippines entered into a string of multi-billion peso contracts with a company called Pharmally Pharmaceuticals, despite the fact that Pharmally is a small firm that was incorporated only in 2019 and lacked the funds, experience, and credibility to handle major government contracts. It was later revealed that Pharmally has direct ties with Chinese businessman Michael Yang, a close friend and former advisor of President Rodrigo Duterte. While direct corruption in this case has not yet been proven, the circumstances are extremely suspicious. And this is just one high-profile example of questionable COVID-related procurement deals. Speaking more generally, it is quite likely that widespread corruption contributed to the Philippines’ abysmal COVID-19 response (see, for example, here and here). Before the next crisis hits, it is essential that the Philippines learn how to better insulate its emergency procurement system from corruption risks. This is not to say that the procurement rules that apply in ordinary situations—including the usual transparency and integrity safeguards—must apply with full force during emergencies. In states of emergency, acting quickly can make the difference between life and death, and so it is reasonable to alter or relax public procurement rules to some extent, even if this raises the risks of corruption and other problems. But it is possible to design procurement systems so as to limit the ability of corrupt actors to take advantage of emergency procurement rules to enrich themselves. In the Philippines, the experience with corruption during the COVID-19 pandemic suggests the following reforms—influenced by international best practices but tailored to the Philippines’ particular context—to clean up the country’s flawed emergency procurement system:

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Should International Organizations Like the IMF Require More Anticorruption Conditions on Their Pandemic Emergency Funding?

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In response to the unprecedented COVID-19 pandemic, governments across the world are taking emergency measures to secure and distribute necessary medical equipment to hospitals, front-line medical workers, and at-risk groups. Moreover, to respond to the dangerous economic crisis that has resulted from stay-at-home orders and other essential public health measures, national governments have rapidly adopted new fiscal programs and other measures that have pushed trillions of dollars out the door. Multilateral institutions like the International Monetary Fund (IMF) have also stepped in to assist countries that have seen their foreign exchange inflows drying up due to a variety of factors associated with the pandemic (including lower international oil prices, lack of tourism receipts, and declining remittance flows). These countries urgently need for foreign exchange to purchase critical medical supplies and equipment from abroad. The IMF has existing facilities for providing emergency funding to address balance of payments shortfalls in times of emergency (the Rapid Credit Facility (RCF) and the Rapid Financing Instrument (RFI)), and has  already begun providing funding under these programs, with more funds likely on the way. In contrast to other IMF programs, there are relatively few conditions that recipients need to satisfy up front in order to have access to RCF/RFI financing.

The global anticorruption community has been understandably worried about the risks that emergency response funds could be misappropriated or mismanaged, which would impede the collective public health efforts. (See, for example, the pieces collected here and here). For example, Transparency International has pushed for open data publishing on public procurement, and Sarah Steingrüber, the Global Health Lead for CurbingCorruption, recently made the case on GAB for the establishment of oversight task forces and for directing some donor funds to enhancing anticorruption safeguards (i.e. public financial management improvements and CSO funding). With respect to the IMF in particular, a group of 99 civil society organizations (CSOs) sent an open letter to the IMF, pushing back against what they characterized as the Fund’s “retroactive approach” to anticorruption efforts, and instead called for loan conditions that would require recipient governments to (1) receive all IMF funds in a single Treasury account, (2) hire independent auditors within six months of disbursement, (3) publish a procurement plan with names and beneficial ownership information, and (4) repeal or amend laws that prevent groups from safely monitoring government spending.

While nobody seriously questions the importance of reducing corruption and other forms of “leakage” of funds spent to fight the coronavirus and its associated economic dislocation, much of the emerging commentary from the anticorruption community seems to lack a sufficient appreciation of, and engagement with, the trade-offs between controlling leakage and ensuring a sufficiently rapid response. The CSOs’ open letter to the IMF is an illustrative example of the apparent neglect of these trade-offs. Continue reading →

Guest Post: Anonymous Companies Are Undermining Mexico’s Public Health

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Today’s guest post is by Miguel Ángel Gómez Jácome, the Communications Coordinator at the Mexican civil society organization Impunidad Cero (Zero Impunity).

The COVID-19 pandemic has already affected millions of people. (As of the time this piece was initially drafted, around 2 million people had been infected; the exponential spread of the virus means that by the time this piece is published, that number is likely to be much higher.) And while Mexico has not yet been as severely impacted as other countries, official statistics (which likely understate the true prevalence) already report thousands of infections and hundreds of deaths. To confront this problem, Mexico, like other countries, will need to marshal its resources effectively. Unfortunately, though, Mexico’s ability to manage the COVID-19 epidemic is threatened by Mexico’s epidemic of embezzlement in the health sector, much of it facilitated by anonymous shell companies. This widespread corruption drains away vital public resources needed to combat public health emergencies like the COVID-19 pandemic.

In March 2020, two civil society organizations (Justicia Justa (Just Justice) and Impunidad Cero (Zero Impunity)), documented the extent of the problem in a research report entitled Fake Invoices: The Health Sector Epidemic. The research found that between 2014 and 2019, 837 shell companies issued 22,933 fake invoices to 90 health institutions across the country (in 30 of Mexico’s 32 states, as well as the federal government), ultimately embezzling a total of over 4 billion pesos (roughly $176 million US dollars) from the health sector—an amount that could have paid for around 80,000 hospital beds or between 3,400 and 6,900 ventilators. (To put this in context, Mexico currently has 5,000 ventilators in the whole country, and the government is looking to acquire 5,000 more.) And the problem is only getting bigger: According to Mexico’s Tax Administration authority (the SAT), the number of anonymous shell companies in the country has increased from 111 in 2014 to over 9,000 in 2020.

To crack down on the abuse of shell companies to embezzle public funds from the health sector (as well as other sectors), the authors of the Fake Invoices report propose three responses: Continue reading →

New Podcast, Featuring Sarah Steingrüber

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A new episode of KickBack: The Global Anticorruption Podcast is now available. In this week’s episode, I interview Sarah Steingrüber, an independent consultant on corruption and public health issues. Among her other activities in this area, she currently serves as the global health lead for the CurbingCorruption web platform, and was the co-author of the U4 Anti-Corruption Resource Centre’s report on Corruption in the Time of COVID-19: A Double-Threat for Low Income Countries. Much of our conversation naturally focuses on how corruption and related issues may intersect with the coronavirus pandemic and its response, in particular (1) misappropriation of relief spending, and (2) how some corrupt leaders may use the coronavirus pandemic as a pretext to eliminate checks and oversight. A central tension we discuss is how the urgency of emergency situations affects the sorts of measures that are appropriate, and draws on lessons from prior health crises such as the Ebola outbreak in West African in 2013-2016. We then discuss other more general issues related to corruption and health, such as how the monetization and privatization of health may contribute to undue private influence on decision-making processes in the health sector.

You can find this episode here. You can also find both this episode and an archive of prior episodes at the following locations:

KickBack is a collaborative effort between GAB and the ICRN. If you like it, please subscribe/follow, and tell all your friends! And if you have suggestions for voices you’d like to hear on the podcast, just send me a message and let me know.

Commentaries on Corruption and the Coronavirus Pandemic: Update

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A couple weeks back, I said I was thinking about trying to collect and collate the ever-increasing number of commentaries on the relationship between corruption and the coronavirus/COVID-19 pandemic. Several readers wrote to encourage me to continue, so I’m doing another update. I’m not sure how long I’ll be able to keep this up, since commentaries in on the corruption-coronavirus connection, like the virus itself, seem to be growing at an exponential rate. I certainly don’t make any claims to comprehensiveness (and thus I beg the forgiveness of anyone whose contributions I’ve neglected to include in the list below). But here are some new pieces I came across, followed by a chronological list of corruption-coronavirus commentaries to date: Continue reading →

Guest Post: Measures To Counter Corruption in the Coronavirus Pandemic Response

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Today’s guest post is from Sarah Steingrüber, an independent global health expert and Global Health Lead for CurbingCorruption.

The coronavirus pandemic is a global health challenge the likes of which has not been seen in over a century. The outbreak demands swift and bold action not only in the direct response to the pandemic, but also in ensuring that monies are correctly spent, that companies do not profit unfairly from misfortune, and that power is not abused by our leaders.

Two weeks ago, I published a commentary on this blog that identified some of the critical corruption risks associated with the response to the coronavirus pandemic. In today’s post, I turn from a diagnosis of the risks to some possible solutions. In particular, I want to highlight four types of measures that will help to mitigate some of the corruption risks that were identified in my previous post. Continue reading →

New Podcast, Featuring Taryn Vian

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A new episode of KickBack: The Global Anticorruption Podcast is now available. This episode is particularly timely, as it features an interview with Taryn Vian, a professor at the University of San Francisco whose research focuses on the links between corruption and public health. Unsurprisingly, much of our discussion revolves around the current coronavirus pandemic, and how to address and manage the corruption challenges associated with the current health emergency. But our broad-ranging conversation also covers the corruption-health connection in more normal times (including issues like informal payments to doctors and embezzlement or misappropriation of medical supplies), as well as lessons learned from corruption in previous public health emergencies, such as the Ebola outbreak in West Africa in 2013-2016.

You can find this episode here. You can also find both this episode and an archive of prior episodes at the following locations:

KickBack is a collaborative effort between GAB and the ICRN. If you like it, please subscribe/follow, and tell all your friends! And if you have suggestions for voices you’d like to hear on the podcast, just send me a message and let me know.

More Commentaries on Corruption and the Coronavirus Pandemic

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Perhaps unsurprisingly, folks in the anticorruption community have started to generate a fair amount of commentary on the links between the coronavirus pandemic and corruption/anticorruption; these pieces approach the connection from various angles, including how corruption might have contributed to the outbreak and deficiencies in the response, the importance of ensuring adequate anticorruption safeguards in the various emergency measures being implemented to address both the public health crisis and the associated economic crisis, and concerns about the longer term impact on institutional integrity and checks and balances. Last week I posted links to four such commentaries. Since then, we’ve had two commentaries on the corruption-coronavirus relationship here on GAB (yesterday’s post from Sarah Steingrüber, and last week’s post from Shruti Shah and Alex Amico). Since then, I’ve come across some more, and I thought it would be useful to provide those additional links, and perhaps to try to start collecting in one place a list of commentaries on corruption and coronavirus. The new sources I’ve come across are as follows:

In case it’s helpful to readers, I may start to compile and regularly update a list of corruption-coronavirus resources. The ones I’ve got so far (including those noted above):

I’m sure there are more useful commentaries, and many more to come over the coming weeks. I’m not sure if I’ll be able to keep a comprehensive list, but I’ll do my best to provide links to the resources I’m aware of, so if you know of useful pieces on the corruption-coronavirus link, please send me a note.

Thanks everyone, and stay safe.

Guest Announcement: Special Issue on Fighting Corruption in the Health Sector

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Continuing this week’s theme of highlighting resources on the links between corruption/anticorruption and the coronavirus pandemic, in today’s guest post Sarah Steingrüber, an independent global health expert and Global Health Lead for CurbingCorruption, announces the following new resource on fighting corruption in the health sector:

Last week, the open-source academic journal Global Health Action, published a special issue on anticorruption, transparency, and accountability in the health sector. Although not about the COVID-19 situation specifically, this special issue—a joint undertaking with the World Health Organization—addresses crucial and highly relevant issues related to the health sector’s ability to prevent, detect, and sanction corruption, in order to address the threats that corruption poses to the health system’s ability to perform effectively during both crises and normal times.

After an introductory overview by Theadora Koller, David Clarke, and Taryn Vian, the special issue includes seven articles:

Some Recent Commentaries on Corruption and the Coronavirus Pandemic

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As I noted last week, although this blog is going to keep on going during the COVID-19 crisis (though perhaps with somewhat reduced output), it’s a bit challenging to proceed with blogging about one problem (corruption) when another problem (the COVID-19 pandemic) is so much at the forefront of everybody’s mind. And in that last post, I noted that although there’s a well-known connection between corruption and public health generally, “so far corruption doesn’t seem to be a major issue in the COVID-19 situation.”

I think perhaps I spoke too soon. We’re already starting to see a number of interesting and useful commentaries on the connections between corruption/anticorruption and the COVID-19 pandemic (several of which readers helpfully noted in comments on last week’s post). I do think we should always try to be a bit cautious about straining to find links between whatever it is we work on and the most salient problem of the day. (I can’t help but remember that in the aftermath of the 9/11 attacks, people suddenly discovered that whatever problem they’d been working on for the past decade was inextricably linked to the threat of global terrorism.) But in this case I’m persuaded that the links are particularly plausible and important that this is something that deserves further study.

At some point, I may post some original content on this topic to GAB, but for now let me just provide links to some of the interesting early commentaries on the possible connections between corruption and the COVID-19 pandemic:

  • Natalie Rhodes, who works with the Transparency International Health Initiative, has an essay–subsequently expanded into a longer feature on Transparency International’s website–discusses some of the corruption risks during the response to an epidemic, including shortage-induced bribery risks, diversion of emergency response resources, and kickbacks in the procurement process.
  • Jodi Vittori, a fellow at the Carnegie Endowment, has a piece entitled “Corruption Vulnerabilities in the U.S. Response to Coronavirus,” which similarly emphasizes corruption risks in medical supply chains, and the greater difficulty in securing transparency and accountability during times of crisis. She lays out a series of measures that, she argues, must be integrated into all COVID-19 response legislation, and also suggests some things that ordinary citizens can do.
  • Another Carnegie Endowment fellow, Abigail Bellows, has a piece called “Coronavirus Meets Corruption: Recommendations for U.S. Leadership,” which emphasizes that the combination of systemic corruption and the COVID-19 crisis could prove especially devastating in the developing world, and suggests that the U.S. government could help ameliorate this situation by targeting more of its foreign aid at strengthening fiscal management systems, and by enacting a number of currently-pending bills that, while not specifically related to corruption in the health sector, would provide greater U.S. support to the fight against kleptocracy abroad.
  • In one of the earliest blog commentaries suggesting a corruption-coronavirus link, Gretta Fenner and Monica Guy of the Basel Institute on Governance wrote a post for the FCPA blog in late January that suggested the original coronavirus outbreak in China may have been linked to the illegal wildlife trade, and that the illegal wildlife trade is made possible by corruption–a string of connections that leads them to ask, in the title of their post, “Did corruption cause the deadly coronavirus outbreak?”

I’m sure that in the days and weeks ahead, more commentaries will appear that explore both the ways that corruption may have contributed to, or exacerbated the impact of, the coronavirus pandemic, and the corruption risks associated with the policy responses to this crisis. I probably won’t be able to keep up with all of them, but I’ll do my best to feature them on the blog when I can, and if readers are aware of other useful commentaries, please send me the information through this blog’s contact page.

Thanks everyone, and stay safe.